The use of an Inhaled Surfactant in Patients With Severe and Extremely Severe new Coronavirus Infection COVID-19 With Concomitant Cardiovascular Pathology

Author:

Trofimov N. A.1ORCID,Babokin V. E.2ORCID,Dubova A. V.3,Koshelkova A. V.4,Dimitrieva O. V.3,Rodionov A. L.3,Abizov I. N.5,Oreshnikov E. V.5,Anurov S. A.5,Zamlikhanova S. S.5,Igonin Yu. A.5ORCID,Gordeeva K. E.3,Surkova T. V.5,Nikolsky V. O.6ORCID

Affiliation:

1. I.N. Uljyanov Chuvash State University, Cheboksary; Chuvash Republic Cardiological Dispensary, Cheboksary; Institute for Advanced Medical Education, Cheboksary; Federal Center for Traumatology, Orthopedics, and Arthroplasty, Cheboksary; Privolzhsky Research Medical University, Nizhny Novgorod

2. I.N. Uljyanov Chuvash State University, Cheboksary; Chuvash Republic Cardiological Dispensary, Cheboksary; Institute for Advanced Medical Education, Cheboksary

3. I.N. Uljyanov Chuvash State University, Cheboksary; Chuvash Republic Cardiological Dispensary, Cheboksary

4. Chuvash Republic Cardiological Dispensary, Cheboksary

5. I.N. Uljyanov Chuvash State University, Cheboksary

6. Nizhny Novgorod Regional Clinical Antituberculosis Dispensary, Nizhny Novgorod

Abstract

Aim      To study the effectiveness of nebulized surfactant therapy as a part of a multimodality treatment of severe and extremely severe COVID-19 viral pneumonia with concomitant cardiovascular diseases (CVDs).Material and methods  This retrospective controlled study analyzed a multimodality treatment of 38 patients with severe and extremely severe COVID-19 viral pneumonia and concomitant CVDs who were administered nebulized surfactant for correction of acute respiratory distress syndrome (ARDS). The control group consisted of 105 patients with severe and extremely severe novel coronavirus infection with concomitant CVDs who were not administered surfactant as a part of the multimodality therapy.Results Administration of nebulized surfactant as a part of the multimodality treatment in patients with COVID-19 allowed alleviating the severity of respiratory insufficiency (р<0.001), which decreased the death rate of patients with severe and extremely severe COVID-19 and undoubtedly demonstrated the effectiveness of this medicine. The timely multimodality therapy, including nebulized surfactant, improves the course of the disease. Thus, the absence of a possibility for administering nebulized surfactant for more than 4 days was associated with fatal outcomes (р=0.045).Conclusion      Administration of nebulized surfactant as a part of the multimodality treatment of severe and extremely severe COVID-19 and concomitant CVDs increases the survival (р<0.001) and reduces the mortality by 46 %. The risk factors of an unfavorable outcome of this disease include an age older than 65 (р=0.020), a positive polymerase chain reaction test (р=0.037), a ferritin concentration at baseline >600 mg /ml (р<0.001), and a surfactant treatment duration < 4 days (р=0.045). Further study of the efficacy of nebulized surfactants as a part of the multimodality therapy is required and should include randomized clinical trials with a large number of patients and the development of distinct criteria for the treatment of ARDS. 

Publisher

APO Society of Specialists in Heart Failure

Subject

Cardiology and Cardiovascular Medicine

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